At least half of the people becoming infected with HIV each year are under the age of 25.1 Youth at risk for HIV come from various ethnicities, genders, sexual orientations and other socio-cultural characteristics. However African American teens (ages 13-19) accounted for 65% of new AIDS cases reported among teens in 2002, even though they are only 15% of U.S. teenagers.2

Factors to Consider When Promoting and Providing HIV Prevention and Treatment

Low Perception of Risk

Many youth feel they are at no or low risk of contracting HIV. However, the facts show that they are at risk, and parents and adults must also accept these facts. As mentioned above, at least one half of all new HIV infections are estimated to be among youth ages 25 and under. And most of them are infected through unprotected sex.4 This age group is characterized by experimentation, self-esteem conflicts and identity formation, which can result in risk-taking sexual and drug use behaviors. Support and appropriate prevention education can help youth maintain a low level of risk.

Inadequate Prevention Education

Youth receive conflicting messages about sex through the media, friends and sometimes parents. A variety of legal and social factors determine the level of sexual education teenagers get in schools, so the level of knowledge and ability to prevent HIV and other STDs varies from community to community. According to the CDC, "research has clearly shown that the most effective programs are comprehensive ones that include a focus on delaying sexual behavior and provide information on how sexually active young people can protect themselves."3 In addition, prevention must be provided to adolescents who are drop-outs, homeless or runaways, and those in the juvenile justice system. Young people may be more receptive to information they receive from peers because the social and cultural issues they face differ from adult experiences.5

Confidentiality Concerns

Minors are legally allowed to test for STDs without adult consent; however, some states require minors to have the consent of a guardian to receive HIV testing. Also, some states require that clinics report treatments for STDs and HIV. It's not required by law to report an HIV-positive status to the student's school, that's a personal decision. If a student or family chooses to disclose to school authorities, the student's right to privacy must be assured.5

Suggestions for Effective Services and Campaign Messages

This is a culturally diverse population, and prevention efforts must be tailored to reach the target groups as there is no single approach that will effectively reach all groups.

Invite parents to learn about your services and how they can help teenagers stay safe.

Support youth who decide to postpone sex, and help sexually active youth be educated and develop a healthy self-esteem so they will protect themselves.

If peer educators and counselors are effective with your population, hire them and involve them in the design and implementation of services and campaigns.

Include HIV-positive youth, as visibility can help reduce the stigma of HIV. Develop support networks for HIV-positive individuals.

Create NHTD events near schools or in targeted neighborhoods to make it easy for young people to attend.

Make sure your services are truly confidential, as that will inspire trust in young people concerned about parents or school officials questioning or learning about their HIV status.

Design your services and train your staff to be youth-friendly and to earn youth's trust.

Many individuals don't test or return for their results for fear that a positive result will damage their self-image and their family and social relationships.6 Counseling staff should be trained to discuss this issue.

Contact your local public health authority to learn your state's policies around services for minors.

Provide staff training as needed.

References

NIAID, HIV/AIDS Statistics, July 2004.

The Henry J. Kaiser Family Foundation, African Americans and HIV/AIDS, February 2005.

CDC, Fact Sheet: Young People at Risk -- HIV/AIDS Among America's Youth, 2002.

The Henry J. Kaiser Family Foundation, The HIV/AIDS Epidemic in the United States, March 2004.

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